Important program strengths were the "local champions" (Pain Resource Nurses) and the ongoing support and expertise of the pain committee. Systematic evaluation was important to document successes as well as areas requiring further focus.

In order to achieve their desired aims, evidence-based, theory-driven drug education programmes need to be implemented as intended. Measurement of 'fidelity of implementation' is now included increasingly as part of programme evaluation, although measures and methods are sometimes limited. A more sophisticated approach to assessing implementation fidelity, based on Dane & Schneider's (1998) five dimensions, was used to examine the classroom curriculum element of the Blueprint programme. Blueprint was the largest and most rigorous evaluation of a multi-component drug prevention programme to date in the United Kingdom. Lessons were, overall, delivered with reasonable fidelity, although teachers did not always understand the thinking behind particular activities, suggesting that training needs to focus not only on content and methods but why particular approaches are important. Different dimensions of fidelity could conflict with one another: under pressure of time, generic elements and processes designed to reflect on learning were sometimes sacrificed in order that core drug education activities could be completed. Future drug education curricula need to build in more flexibility for discussion without compromising core evidence-based elements. Even with substantial training and support, individual variations in delivery were found, although few differences were found between teachers with prior expertise and teachers new to drug education. The methods and measures applied in the Blueprint study all represent attempts to improve on previous measures in terms of both reliability and sensitivity. In this respect the Blueprint study represents a valuable contribution to the science of implementation fidelity.

The purpose of this study is to examine the career trajectories of nurse teachers. The main focus of the study is the process of transition from nurse to teacher. The study looks at the anticipations, expectations, contrasts and changes encountered by nurse teachers when first embarking on the role. The interest lay in obtaining the teachers' view of their career trajectories and their experience of status transition. An ethnographic approach was adopted, and in-depth interviews were carried out with nurse teachers, to capture the breadth and depth of the teachers' experience. The teachers all volunteered to participate in the study, so are in no way statistically representative of their professional group. In analysing the data the mode of qualitative analysis called 'grounded theory' was modified and adopted. In this approach data collection, analysis and theory stand in reciprocal relationship to each other. The study operates at two levels. It relates to issues which appear to be meaningful only to the nurse education audience, but it also engages with the more anthropological concern of status passage. Finally, the results are discussed highlighting the many areas which were identified as causing concern and using the concept of 'identity' to offer an explanation for the 'troublesome-duality' experienced by nurse teachers.

Aims: The study examined normative school drug-education practice in Scotland and the extent to which it reflected the evidence base for effective drug education. Methods: Current guidance in Scotland was compared with systematic review evidence on drug-education effectiveness; a survey was mailed to primary, secondary and special schools (928 questionnaires returned); and 100 drug-education lessons were systematically observed across 40 schools. Findings: Nearly all schools provided drug education but modes of delivery and learning approaches did not always reflect the evidence base. There was a strong reliance on information provision and more limited use of social influences, resistance and normative approaches. Teaching was reasonably interactive, particularly with teachers who had been trained. Although drug education was provided across all school years, there was limited linkage and some duplication of content for different age groups. The rationale for resource use was not always clear, and some resources were inappropriate for pupils. Conclusions: Recommendations for closing the gap between evidence and practice include: guidance that emphasizes more strongly the weight of evidence behind recommendations; training in effective approaches; greater continuity and integration of drug education across the whole curriculum; a review of resources; and better guidance on using external visitors

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